The Office of Enterprise Data and Analytics, within the Centers for Medicare & Medicaid Services (CMS), has developed the CMS Program Statistics, an information product which is replacing the Medicare and Medicaid Statistical Supplement. The CMS Program Statistics is an online statistical report that includes tables describing characteristics of the Medicare-covered populations, use of services, and expenditures under these programs, as well as Medicare providers serving beneficiaries.
Full Answer
How can statistical methods be used to analyse healthcare resource use?
We review statistical methods for analysing healthcare resource use and costs, their ability to address skewness, excess zeros, multimodality and heavy right tails, and their ease for general use. We aim to provide guidance on analysing resource use and costs focusing on randomised trials, although methods often have wider applicability.
What is the best statistical analysis software for biomedical research?
At present, many statistical software like SPSS, R, Stata, and SAS are available and using these softwares, one can easily perform the statistical analysis but selection of appropriate statistical test is still a difficult task for the biomedical researchers especially those with nonstatistical background.[2]
What are the measures used in inferential statistics?
In the inferential statistics, hypothesis is constructed using these measures and further in the hypothesis testing, these measures are used to compare between/among the groups to calculate significance level. Suppose we want to compare the diastolic blood pressure (DBP) between three age groups (years) (<30, 30--50, >50).
How to select the appropriate statistical method for data analysis?
To select the appropriate statistical method, one need to know the assumption and conditions of the statistical methods, so that proper statistical method can be selected for data analysis.
What is MBSF in beneficiary?
Is stroke rate smoothed?
About this website
How is Medicare data collected?
Abstraction of administrative/claims data. Medicare administrative data or Medicare Fee-for-Service claims (administrative) data, also known as health services utilization data, are collected by the Centers for Medicare and Medicaid Services (CMS) and derived from reimbursement information or the payment of bills.
What kind of data does CMS collect?
The data held currently by CMS come from a variety of sources, of which the most important is claims for all types of services provided. All claims contain basic diagnostic information, as well as information on date of service, the type of service provided, and the identity of the prescribing physician.
Where does CMS get its data?
The primary data sources for Medicaid statistical data are the Medicaid Statistical Information System (MSIS), the Medicaid Analytic eXtract (MAX) files, and the CMS-64 reports.
What data is reported to CMS?
Data and Program ReportsEP Recipients of Medicare EHR Incentive Payments (ZIP) (File 1 of 2)EP Recipients of Medicare EHR Incentive Payments (ZIP)(File 2 of 2)EH Recipients of Medicare EHR Incenitve Payments (ZIP)Medicare Advantage Organization Providers Payments (ZIP)
How do I access Medicare claims data for research?
The ResDAC website provides all of the necessary information on how to obtain Medicare and/or Medicaid data for researchers, including requests for both restricted and limited datasets as well as public use files (PUF)/non-identifiable files.
Is CMS data reliable?
In general, data elements provided by CMS provide consistent and reliable information. When assessing data quality, a good place to start is with the data dictionaries created for each file. The data dictionaries (record layouts) contain information about some assumptions, data combinations, limitations, etc.
What is CMS Medicare tracking system?
The CMS Analysis, Reporting, Tracking (CMSART) system maintains business and contract related information about contractors that work with CMS. It tracks contractor cost reports, all deliverables, and estimated versus actual costs for contracts awarded.
What is Medicaid Analytic eXtract?
The Medicaid Analytic eXtract (MAX) data is a set of person-level data files on Medicaid eligibility, service utilization, and payments. The MAX data are created to support research and policy analysis. The MAX data are extracted from the Medicaid Statistical Information System (MSIS).
Are Medicare claims public data?
CMS is committed to increasing access to its Medicare claims data through the release of de-identified data files available for public use. These files are available to researchers as free downloads in CSV format. They contain non-identifiable claim-specific information and are within the public domain.
What are CMS reports?
The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).
What is the purpose of CMS reporting?
The purpose of Section 111 reporting is to enable CMS to pay appropriately for Medicare-covered items and services furnished to Medicare beneficiaries.
What is Hcup database?
The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of databases, software tools and related products developed through a Federal-State-Industry partnership and sponsored by AHRQ.
What are the two main statistical methods used in data analysis?
Two main statistical methods are used in data analysis: descriptive statistics, which summarizes data using indexes such as mean and median and another is inferential statistics, which draw conclusions from data using statistical tests such as student's t-test.
What is statistical method?
In statistics, for each specific situation, statistical methods are available to analysis and interpretation of the data. To select the appropriate statistical method, one need to know the assumption and conditions of the statistical methods, so that proper statistical method can be selected for data analysis.[1] .
What are the two types of statistical methods?
Inferential statistical methods fall into two possible categorizations: parametric and nonparametric. All type of statistical methods those are used to compare the means are called parametric while statistical methods used to compare other than means (ex-median/mean ranks/proportions) are called nonparametric methods.
What is statistical method in biostatistics?
In biostatistics, for each of the specific situation, statistical methods are available for analysis and interpretation of the data. To select the appropriate statistical method, one need to know the assumption and conditions of the statistical methods, so that proper statistical method can be selected for data analysis.
Why is selection of appropriate statistical method important?
Selection of appropriate statistical method is very important step in analysis of biomedical data. A wrong selection of the statistical method not only creates some serious problem during the interpretation of the findings but also affects the conclusion of the study. In statistics, for each specific situation, ...
Abstract
We review statistical methods for analysing healthcare resource use and costs, their ability to address skewness, excess zeros, multimodality and heavy right tails, and their ease for general use. We aim to provide guidance on analysing resource use and costs focusing on randomised trials, although methods often have wider applicability.
1. INTRODUCTION
It is well recognized that statistical analysis of healthcare resource use and cost data poses a number of difficulties. These non-negative data often exhibit substantial positive skewness, can have heavy tails and are often multimodal (e.g. with a mass at zero for non-users).
2. REVIEW METHODS
The review aims to identify the analytical methods currently employed or suggested for evaluating healthcare resource use and costs that are likely to be applicable to randomised trial data. A number of exclusion criteria were employed in order to limit the scope of what might potentially include a very large literature.
3. REVIEW RESULTS
Based on the reviewed papers, 12 categories of analytical approaches currently employed to evaluate mean healthcare resource use and costs were identified. These categories are outlined below together with a brief description. The review templates are available in the web appendix ( http://www.herc.ox.ac.uk/downloads/support_pub ).
4. DISCUSSION
Two main approaches towards comparing means are often employed. First, direct comparison of means and their uncertainty when no adjustment for covariates is present is widely used. Second, allocation to treatment as a covariate in a regression model is considered.
5. GUIDANCE TO ANALYSTS BASED ON THIS REVIEW
Most of the methods identified in the review have undergone limited testing in different situations and their use in practice is very restricted. Therefore, no detailed guidance can be provided. In making practical recommendations, we have not advocated many methods suggested in the literature.
6. FUTURE RESEARCH
Further research comparing the performance of different methods on simulated as well as experimental trial data is highly desirable. The literature review has suggested that mixture models could have significant advantages in modelling skewed, heavy-tailed, multimodal data.
What is the mandate for extrapolation in Medicare?
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 mandates that before using extrapolation to determine overpayment amounts , there must be a determination of sustained or high level of payment error, or documentation that educational intervention has failed to correct the payment error.
What is predictive modelling?
Predictive modelling is the process by which a model is created or chosen to try to best predict the probability of an outcome. In many cases the model is chosen on the basis of detection theory to try to guess the probability of a signal given a set amount of input data, for example given a claim determining how likely that it is compliant.
What is data mining?
Data mining is the process of sorting through large amounts of data and picking out relevant information. It is usually used by business intelligence organizations, and financial analysts, but is increasingly being used in the sciences to extract information from the enormous data sets generated by modern experimental and observational methods.
Is a random sample a representation?
Since a valid random sample is a representation , or a “mirror image” of the population, it is defensible to project sample findings onto the population from which the sample was drawn
Purpose
This article provides resources for obtaining statistics and reports related to the Medicare and Medicaid programs and their beneficiaries. The following Medicare/Medicaid statistical and summary data resources address some of the most common requests for this type of information. These are by no means exhaustive.
Article Information
The process and materials mentioned as part of this KnowledgeBase article are current, as of the publication date on the article, to the best of our knowledge. The examples provided are correct in the aggregate but may not apply to every subgroup or circumstance that a researcher may wish to study.
What is the purpose of the Medicaid toolkit?
The purpose of this toolkit is to serve as a practical training guide to help State Medicaid Fraud Control Units (MFCUs) design effective statistical samples. The guide is not intended to establish formal standards or to restrict the methods available to the MFCUs to complete their mission. Because statistics is a broad field with a wide variety of effective and valid methods, a sample or estimate may be valid even if it does not follow the steps in this guide.
How to allocate sample items across strata?
The easiest way to allocate sample items across strata is to set the sample size in each stratum so that it is proportional to the number of items within the frame. For example, suppose there is a frame with 1,000 records that is split into 3 strata of 200, 300, and 500 records. For a sample of 200, the proportional allocation would be calculated as (200/1,000) × 200 = 40 items for the first stratum, (300/1,000) × 200 = 60 items for the second stratum, and (500/1,000) × 200 = 100 items for the third stratum. The benefit of this approach is that the design will almost always work as well or better than a simple random sample of the same size. The disadvantage is that this approach may not be as precise as methods that emphasize higher impact strata.
What is an outlier in statistics?
An outlier arises when an error amount for an item is significantly larger than the remaining items in the stratum (or the frame if the sample is not stratified). Outliers are not generally a concern if the dollar values in the frame are similar or if the frame has been stratified in a reasonable manner.
Why do investigators use the claim as the sample unit?
The reasons for this choice were that the investigators needed to review individual claims as part of their planned investigative procedures, and the error amounts obtained from their reviews were likely to vary less across claims than beneficiaries.
What is variable estimate?
variable estimate involves the measuring of a number for each item in the sample. Dollar amounts are the most commonly calculated variable estimates in the healthcare domain.
What is the RAT stats?
The auditors used RAT-STATS to estimate the amount of the unallowable payments for NET services and to estimate the financial impact of the deficiencies associated with driver and vehicle maintenance checks. The confidence interval for this estimate was calculated at the 90-percent confidence level.
What is subpoenaed medical records?
The investigators subpoenaed the medical records associated with the claims selected in the sample. Once the investigators received the subpoenaed records, the investigators gave the records to a trained medical coder who reviewed each sampled item and identified whether the claimed amounts were
What is MBSF in beneficiary?
The following is a list of inclusion criteria applied to the beneficiaries in the Master Beneficiary Summary File (MBSF). These inclusion criteria are used to determine what months an individual beneficiary could be eligible for inclusion. A beneficiary is considered eligible for any given month if he or she is eligible within that month for at least 1 day.
Is stroke rate smoothed?
All county-level heart disease and stroke rates and percentages can be displayed as either “spatially smoothed” or not. Spatial smoothing is a technique used to make estimates more statistically reliable and to generate stable estimates for counties with small populations. County-level data were spatially smoothed using a Local Empirical Bayes algorithm to stabilize risk by borrowing information from neighboring geographic areas.